异体骨联合自体骨髓移植治疗骨囊肿

目的介绍异体骨联合自体骨髓移植治疗骨囊肿的手术方法。方法2004年2月～2006年3月,共收治骨囊肿13例,男6例,女7例;年龄5～16岁,平均11.5岁。其中肱骨近端5例,股骨颈2例,股骨干3例,胫骨上段2例,胫骨下段1例;合并病理性骨折5例。所有患者均行瘤体刮除、异体骨与自体骨髓联合移植术,8例加行器械固定术。结果术后5例切口期愈合;8例切口引流物150ml以上,其中5例切口渗液,3例伤口延期愈合。全部获随访6个月～2年,根据Capanne标准,术后X线片达级愈合10例,级3例,时间为3.5～8个月,平均5.2个月,无1例复发;未见再骨折发生;肢体功能基本恢复。结论异体骨联合自体骨髓移植治疗骨囊肿是一种安全有效的手术方法。

TREATMENT OF BONE CYST BY TRANSPLANTATION OF AUTOLOGOUS BONE MARROW COMBINED WITH ALLOGRAFT BONE

Objective To investigate the clinical result of treatment of bone cyst by transplantation of the autologous bone marrow combined with the allograft bone. Methods From February 2004 to March 2006, 13 patients with bone cyst were treated by transplantation of the autologous bone marrow combined the the allograft bone. Among the 13 patients, 6 were males and 7 were females, ranging in age from 5 to 16 years, averaged 11. 5 years. In the patients, 5 lesions were located in the proximal humerus, 2 in the femoral neck, 3 in the femoral shaft, 2 in the proximal tibia, and 1 in the distal tibia. Among the patients, 5 had a complication of pathologic fracture. All the patients underwent an erasion of the bone cyst, and then the transplantation of the autologous bone marrow combined with the allograft bone, and 8 of them were also given an instrument fixation. Results The follow-up for 6 months to 2 years after operation revealed that 5 of the patients had an incision healing by the first intention, 5 had an effusion in the incision site, and 3 had a delayed healing of the incision. According to the Capanne criteria, the postoperative X-ray findings indicated that 10 patients had Grade 1 healing, and 3 had Grade I healing. The complete healing took 3.5-8 months, averaged 5. 2 months. There was no recurrence. When the fixation instrument was removed, no pathologic fracture occurred. The function of the upper and lower limbs recovered. Conclusion Transplantation of the autologous bone marrow combined with the allograft bone is an effective and safe procedure fGr treatment of bone cyst.